Anesthesia Coding Alert

Keep track of these details

Every coder knows that even the smallest details can sometimes make a big difference in your claims processing. Check for these two important notations when coding for bilateral procedures - one at the beginning of the process and the other at the end.

1. Determine the patient's initial diagnosis before the procedure. Your diagnosis for bilateral procedures in pain management should include pain (usually in the extremities), and should be documented as such.

2. Monitor reimbursement through your EOBs. Obtaining the correct reimbursement is often the biggest problem coders face when reporting procedures with modifier -50 (Bilateral procedure). Medicare pays 150 percent of the fee schedule when you use modifier -50 (you get full reimbursement for the first side and half reimbursement for the second). Some carriers might overlook the modifier and only pay for one side of the procedure, so verify that they're paying you correctly - and be sure you have the documentation to prove it when you appeal the claim.